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Extraction of cement leakages and malpositioned spindles complicating percutaneous interventions: why, when and how?

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Chiaroni, Pierre-Marie | Premat, Kévin | Shotar, Eimad | Drir, Mehdi | Trebern, Hugo | Beth, Adrien | Bonnet, Baptiste | Mathout, Jugurtha | Bonaccorsi, Raphaël | Morardet, Laetitia | Cormier, Évelyne | Chiras, Jacques | Clarençon, Frédéric

Edité par CCSD ; Springer Verlag -

International audience. ObjectivesCement leakages in soft tissues are a common occurrence during cementoplasty. They may cause chronic pain, and thus treatment failure. Spindle malposition during reinforced cementoplasty may cause vascular, nerve or cartilage injury. Our goal was to evaluate the rate of cement leakage / spindle extraction and describe the techniques used.MethodsThis retrospective monocenter study included 104 patients who underwent reinforced cementoplasty and 3425 patients who underwent cementoplasty between 2012 and 2020. Operative reports and fluoroscopic images were reviewed to identify extraction attempts and their outcomes.ResultsSix patients (5.8%) had a malpositoned spindle, and all of them underwent spindle extraction during reinforced cementoplasty, with an 80% success rate. A total of 7 attempts were performed, using 2 different techniques. One thousand one hundred thirty patients (32%) had a cement leak in soft tissues, and 7 (0.6%) underwent cement leakage extraction during cementoplasty, with a 100% success rate. A total of 10 attempts were performed, using 3 different techniques. No major complication related to the extraction procedures occurred.ConclusionsSpindle malpositions and soft tissue cement leakages are not uncommon. We described 5 different percutaneous techniques that were safe and effective to extract spindles and paravertebral cement fragments.

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